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    find Author "潘振宇" 4 results
    • 封閉式負壓引流聯合前臂皮神經營養血管皮瓣修復手掌皮膚缺損

      總結封閉式負壓引流(vacuum sealing drainage,VSD)聯合前臂皮神經營養血管皮瓣修復手掌皮膚缺損的臨床療效。 方法 2005 年6 月- 2006 年5 月,收治12 例手掌皮膚缺損患者。男7 例,女5 例;年齡17 ~ 45 歲。擠傷3 例,電鋸傷2 例,絞傷4 例,電燒傷1 例,爆炸傷2 例。缺損范圍5 cm × 4 cm ~ 7 cm × 7 cm。采用VSD 待創面肉芽組織新鮮、感染控制后,用前臂內、外側皮神經營養血管皮瓣移位修復手掌皮膚缺損,皮瓣范圍6 cm ×5 cm ~ 8 cm × 8 cm。 結果 術后1 例皮瓣遠端部分壞死,1 例因血腫壓迫出現靜脈危象,經對癥處理后愈合。余患者皮瓣Ⅰ期愈合。供區成活良好。患者獲隨訪4 ~ 15 個月。根據中華醫學會手外科學會功能評定標準:腕關節、掌指關節功能均為優;1 例肌腱功能評分為良,其余為優;感覺評定S1 1 例,S2 2 例,S3 5 例,S3+ 2 例,S4 2 例。 結論 VSD 能減少創面感染機會,為皮瓣修復提供良好組織床。前臂皮神經營養血管皮瓣移位修復手掌部組織缺損,具有耐磨、無攣縮、重建感覺以及色澤與原皮膚相近等優點,是修復手掌部皮膚缺損的良好方法之一。

      Release date:2016-09-01 09:12 Export PDF Favorites Scan
    • 拇指末節軟組織缺損的修復

      目的 總結拇指末節軟組織缺損的修復方法及臨床效果。 方法 2002 年1 月- 2008 年1 月,收治37 例拇指末節軟組織缺損。男24 例,女13 例;年齡17 ~ 52 歲,平均27.4 歲。電鋸傷5 例,沖壓傷24 例,撕脫傷8 例。其中末節指尖組織缺損6 例,指腹12 例,指背9 例,指側方5 例,脫套傷5 例。缺損范圍1.5 cm × 1.0 cm ~ 6.0 cm ×3.0 cm。受傷至入院時間1 h ~ 7 d,平均36 h。根據拇指末節軟組織缺損情況,采用第1 掌骨背側逆行筋膜皮瓣8 例,拇指尺背側逆行島狀皮瓣9 例,示指背側島狀皮瓣13 例,中指動脈側方島狀皮瓣2 例, 甲瓣3 例,第1 掌骨背側逆行筋膜皮瓣聯合示指背側島狀皮瓣2 例。皮瓣切取范圍1.5 cm × 1.0 cm ~ 6.0 cm × 3.0 cm。供區植皮修復。 結果 術后1 例甲瓣修復者拇指傷口感染,1 例示指背側島狀皮瓣血供不良,1 例第1 掌骨背側逆行筋膜皮瓣遠端表皮壞死,均經對癥處理后愈合。其余皮瓣及供區植皮均順利成活,切口Ⅰ期愈合。患者術后均獲隨訪,隨訪時間6 ~ 24 個月,平均15 個月。皮瓣血運、質地、彈性良好。指間關節活動范圍15 ~ 70°,平均56°;掌指關節活動范圍正常。根據1954 年英國醫學研究會感覺功能恢復評定標準:感覺功能恢復為S1 ~ S3+。兩點辨別覺為5 ~ 12 mm。 結論 對拇指末節軟組織缺損選擇適當的皮瓣進行修復,可獲得滿意的臨床效果。

      Release date:2016-09-01 09:08 Export PDF Favorites Scan
    • Evidence-based Guidelines on Medication for Children with Pneumocystosis: A Systematic Review

      ObjectiveTo systematically review quality of evidence-based pneumocystosis guidelines for children, compare the differences and similarities among recommendations, and to provide references for clinical application. MethodsDatabases such as TRIP, PubMed, CNKI, VIP, WanFang Data, CBM, U.S National Guideline Clearinghouse (NGC), and Guidelines International Network (GIN) were searched to collect evidence-based guidelines on medication therapy for children with pneumocystosis. Methodological quality of included guidelines was evaluated according to the AGREE Ⅲ instrument, and the differences and similarities among recommendations were compared. ResultsA total of 3 evidence-based guidelines concerning children with pneumocystosis were included, of which, 2 were made by the USA and 1 by international academic organizations. Only 1 guideline was especially suitable for children, while others were for children of different ages and adults. The results of AGREE Ⅲ scoring showed that, among 6 domains which were rated using the AGREE Ⅲ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation" and "editorial independence" were scored more than 60%; while "applicability" was only scored 46%, 25% and 31%. Besides, the grading of evidence and grading of recommendations were different. The medication recommendations of different guidelines were not the same. ConclusionThe quality of 3 guidelines is not high, and the grading of evidence and the strength of recommendation are still needed to be unified. The target population and the recommendations in the guidelines are different.

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    • Development and preliminary validation of questionnaire for infection process and prevention of 2019 novel coronavirus infection in medical staffs

      ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.

      Release date:2020-07-02 09:18 Export PDF Favorites Scan
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